- Еуромедик, Булевар уметности 29, Београд
"Granular cell" breast tumor.
Др Мерима Горан
This tumor was first described by Abrikossoff in 1926 as “granular cell myoblastoma,” hence the name Abrikossoff tumor. Later, immunohistochemical analyses showed that this tumor is most likely of Schwann cell origin. The origin of this tumor is still poorly understood, but the expression of the S100 protein favors the theory of neuroectodermal origin.
The most common location where this tumor occurs is the tongue, but it can develop in any soft tissue and may be multifocal. About 5-6% of these tumors are located in the breast. It usually occurs in premenopausal women, more frequently in African American women. It has also been described in men, but very rarely.
The most common localization in the breast is the upper inner quadrant, presumably due to rich sensory innervation originating from branches of the supraclavicular nerves.
The clinical presentation of this tumor is a firm, mobile, painless mass in the breast, which is usually solitary but can be multifocal. This tumor often mimics breast carcinoma not only clinically, but also on ultrasound and mammography. On ultrasound, it appears as a solid mass with posterior acoustic enhancement, and on mammography, it can present as a stellate shadow usually without microcalcifications.
Histologically, besides purely benign lesions, these tumors can be atypical, but malignant granular cell tumors are also possible, but extremely rare. Only a few cases have been described.
The following characteristics raise suspicion of the malignant nature of these tumors: heterogeneous signal on breast MRI examination, regional lymphadenopathy, tumors larger than 5 cm or sudden rapid growth of a change that has been present for a longer period of time, and infiltration of surrounding connective tissue.
The therapy is surgical, with complete excision of the tumor. Recurrences are possible with malignant granular cell tumors, and in such cases, the extent of surgery should be appropriate to the stage of the disease with corresponding adjuvant treatment.